Our topic nomination is Polycystic Ovary Syndrome PCOS. The following is a list of clinical questions practitioners consider when managing such casesDo women with PCOS have an increased risk of developing type 2 diabetes compared with women without PCOSDo women with PCOS have an increased longterm risk of developing cardiovascular disease compared with women without PCOS In a woman with PCOS who is not attempting to conceive how do the following medical maintenance therapies compare in effectiveness of treating anovulation and amenorrheaoCombination oral contraceptivesoProgestinoInsulinsensitizing agentsIn a woman with PCOS who is not attempting to conceive how do the following medical maintenance therapies compare in effectiveness of preventing cardiovascular disease and diabetesoCombination oral contraceptives and progestinsoInsulin sensitizing agentsIn women with PCOS who are attempting to conceive how do the following methods of ovulation induction compare with effectivenessoClomipheneoGonadotropinsoOvarian drillingoInsulinsensitizing agents metforminthiazolidinedionesoLetrozoleoIn vitro fertilizationIn women with PCOS is there a benefit to supplementing medical maintenance therapies with behavior modification diet and exercise compared with medical maintenance therapies aloneIn obese women with PCOS does ovarian function improve in women that lose weight compared with obese women that do not lose weightHow does the effectiveness of the following medical agents compare in treating hirsutism in women with PCOSoOral contraceptivesoAntiandrogens spironolactone flutamide finasterideoInsulinsensitizing agentsoEflornithineWomen diagnosed with PCOS.We are interested in improving sequelae from PCOS such as increased type 2 diabetes risk increased cardiovascular risk hirsutism and anovulation leading to female infertility.

This topic is important because of the longterm risks PCOS poses to otherwise healthy women. There are a variety of ways to manage PCOS that need to be considered in a systematic review to be able to provide clinicians with evidencebased options for treatment.

Clinicians will be more equipped to make appropriate treatment decisions for women with PCOS based on the needs of the individual patient resources and limitations unique to the institution or type of practice. Recommendations based on the systematic review will be used by clinicians to optimize treatment and improve outcomes for these patients.

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Professional society

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American College of Obstetricians and Gynecologists

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Stephanie Chang MD MPH Agency for Healthcare Research and Quality